HomeMy WebLinkAbout21390-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22651 Date
OCTOBER 8~ 1993
THIS CERTIFIES that the building NEW DWELLING
Location of Property 725 MARRATOOKA LANE MATTITUCKr N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 115 Block 4 Lot 6
subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 30~ 1993 pursuant to which
Building Permit No. 21390-Z dated MAY 5~ 1993
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ONE FAMILY DWELLING AS APPLIF23 FOR
The certificate is issued to EUGENE H. MISKA
(owner)
of the aforesaid building.
SUFFOLK CO2NTY DEPARTMENT OF HEALTH APPROVAL 93-SO-41-8EPT. 2~ 1993
UNDERWRITERS CERTIFICATE NO. N-291089 - SEPT. 30~ 1993
PLUMBERS CERTIFICATION DATED SEPT. 23, 1993-MATTITUCK PLUMB. & HEAT.
Rev. 1/81
lVOl~M' NO. ~'
TOWN OF $OUTHOLD
BUILD[HG DEPAKTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~°. 21380 Z Date ............... ~../.~...~..'~...... ..........................
/
Permission is hereby granted to:
........ .K. ',..o:......~...~... .~./~ ...................................
..... Z>/~..:...<..z:..~.<. ....~:../..:....t/.Z..:..~ ,
,o.... ~... .~ .:.... ........ ~ ........... .:. ... .~ ~ . ~::2. '>. . : :. :. ~ ~ :~ ~ ...........
.... ~ ........ ~. ~. ,2, .. . . .. ~~ ....... ~:. . . .. . . ,d'//. ./. . ~. .. . ... ,~.~ ....................
at premises located at ...........................~ ................................................ : ..........................
.......................................... ./. .............. ....~...~.~...<....¥......-~..~: ...........................................
......................................... ~ ........................................... .~ .............................................................
County Tax Map No. 1000 Section ...././.....~... Block ......~.... ........ Lot No .....
~:~v:"~"~,
Building Inspector.
Rev. 6~30~80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~65-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% leado
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6.Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pro-existing" land uses:
i. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2.Certificate of Occupancy on Pre-existing Building - $100.00
3.Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4.Updated Certificate of Occupancy - $50.00
5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.O0
~ . .~... Date ..... l~/~/~.~ .....................
::ew Construction ....... Id Or Pre-existing Building.
O]
Location of Property... ~ ....... . ~.~.~.~
House No. feet * Hamlet
Onwer or Owners of Property...~~.~..~..~l~. ......................
~ubdivision ............................ Filed Map ............ Lot .....................
Permt~ No .... Date Of Permi .... Applicant. . .
!lealth Dept. Approval ..... '~..~I~ ........... Underwriters Approval .... ~./3ff/~.~ ..........
}lanning Board Approval ........................
~'equest for: Temporary Certificate ........... Final Certicate....~.. ....
......................
TOWN OF SOUTtIOLD
OFFICE OF J3UILDI/qG INSPECTOR
P.O. BOX 728
TOWN IIALL
SOUTIIOLD, N.Y. 11971
TEL. 765-1802
~ E~T I~F I C A T 'i O N
Building Permit No.~L~~
Owner~ . '
I certify that the solder used in
contains less than 2/10 of 1% lead.
the water supply system
Sworn to before me this
19~ .
NOtary Public, ~/~L/~' County . Nota~Lt~lic
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [~j~'RO~JGH PLBG.
FOUNDATION 2ND [,PI' INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE
INSPECTOR _//~h~'~
765-~.802
BUILDING DEPT.
INSPECTION
FOUNDATION SST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] ~iSULATION
FRAMING [~ FINAL
REMARKS:
DATE
INSPECTORS
Victor Lessard
Principal Building Inspector
Curtis Horton
Senior Building lrapector
Thomas Fisher
Building Inspector
Gary Fish
Building Inspector
Vincent R. Wieczorek~
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector
Telephone (516) 765-1802
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
SCOTF L. HARRIS, Supervisor
Southold Town Hall
P.O. Box 1179, 53095 Main Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
September 21, 1993
Eugene ~. Miska
Marratooka Lane
M~ttituck, N.Y.
11952
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XXX
An application for Certificate of Occupancy is
not on file. (Enclosed)
XXX No Underwriters Certificate on file.
XXX The check is (~/not on file.)$25.00
xxx No Health Department Approval on file~
No final inspection has been made.
XXX
No Plumber Solder Certificate on file.
(Ail permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT ~ 21390Z
Please contact our.office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
OuNDA_TION (1st)
OUr';DA T I 0~'~ ( 2nd )
OUGH FRAME &
.PLUMBING
PER N. Y.
STATE ENERGY
CODE
FI:~AL
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[ ] FRAMING
DATE INSPECTO
7GS-Z.80;Z
BUILDING DEPT.
INSPECTION
[p~UNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION AND [ ] INSULATION
[ ] FRAMING
REMARKS:
FINAL
Form No. 6
TOWN OF SOUTIIOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% leado
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If ~ Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
Fees
Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, SwimminE pool $25.00, Accessory building $25.00,
Additions to accessory buildin§ $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildin§ - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
?ce Submitted: $..~. .....
PLIC;~NT
New Construction ....... 01d Or - .
House No. feet Hamlet
9nwer or Owners of Property...~.~6~.~ .~e.-~/~. ..........................
qouaty Tax Map No 1000, Sectio ...l/ . ..... ..... ........ ...... .............
2ubdivision ...................
................. Filed Map ............ Lot ......................
?ermit No ...Date Of Permi~ .... Applicant. . .
Dept. Approval .... .~/~..~ ........... Underwriters Approval .... ~'/2~/g~ ..........
:lealth
for: Temporary Certificate ........... Final Certicate....~.. ....
?'equest
oxs!~ 'r uqor
3NV9 VNOOIVWWV~
FORM NO. 1
TOWN OF SOUTHOLD
.'BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
Examined ... · ...., 19 .
Apl~roved .............. 19'.ff..~. Permit No. a'2/~ .~.~.,'~.
BOXRD OF HEALTH
3 SETS OF PLANS
SURVEY
CHECK
SEPTIC. FORH
CALL ......
Disapproved a/c .... ' ...........
............ ' ........... ~ ............ >~ ......... · *</b{
APPLICATION FOR BUILDING PERMIT
Date 19
INSTRUCTIONS
a. This application must be com'pletely filled in by typewriter or in ink and submitted to the B~ilding Inspector, with 3
~sets of plans, accurate plot plan to scriM. Fee according to schedule·
· Plot plan showing location o~ tot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
,cation. i ' · ' '
¢. The work covered by this application may not be commenced before issuance of Building Permit·
d. Upon approval of this applica}ion, the Building Inspector will issued a Building Permit to the applicant. Such permit
shalI be kept on the premises avaflabl~ for inspection throughout the work· '
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Tovqn of Southold, Suffolk County, New. York, and other appllcable Laws, Ordinances or
Regulations, for the construction of]buildings, additions or atterafions, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary i~-~ ~.~ ~~ .
--. · ..... '~.:' .... --,,--v,-- ...............
(Signa~ur~%~'~pphcant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, l~ssee, agent, architect, engineer, general contractor, electrician, plumber or builder·
........................... c. au tu..
Name of owner of premises ...... ~.. i~$ (~a4o'n t~ax~'
e roll or latest deed)
If applicant is a corporation, signatur~ of duly authorized officer.
(Name and title of corporate officer)
Builder s L'cense No
lumber s Ltcense No .......
lectn9 an s Lmense No .....
Other Trade's Licaase No ....
Locatio. n of land on which propos ~d work will be' done
House Number i . Street amlet
Iff. ....... ,ock ....... q.. ........ Lot ....... ¢ ..........
............. Filed Map No ............... Lot ...............
County Tax Map No. 1000 Sectiofi .....
Subdivision ................. + ......
(Name)
2. State existing use and occupancy ~f premises and intended use and occupancy of proposed construction:
b Intended use and occupancy .., ......... .
Repair .... Addition .......... Alteration .........
......... t~emoval .............. Demolition .... ..' ......... Other Work .............
4 Estimated Co t 3.~0. (Description)
t mb (to be paid on filing this application)
5. If dwelling, number of dwelling units .............. Nu er of dwelling units on each floor
· If garage, number of cars .............. ' ............
6. If business, commercial or mi..xed occupancy, specify nature and extent of each type of use ..................
7. Dimensions of exlstlng structures, if any: Front ............... Rear .............. Depth.. ' ' ' '
Height ............... Nmnber of Stories .............
Dimensions of sfime structure with alterations or additions: Front ...... · ........... Rear ..................
Depth ..... ' ................. Height ........ "a~ '..~ ...... '.. Number. 9f ~tories '
8. Dimensionsofentirenewconstruction: Front ...... ~'0 ...... Rear ..... ~'0 ...... ' ............ ~ "'
9. Size of lot: Front ....... ~otStories Depth ..... l~'t'
........... a ......... ~.t~. ........
10. Date of Purchase ..................... Nam e o f~;rm~j,
11. ' .......
Zone or use district in which premises are situated .... ~}~l .................
12. Does proposed construction violate any zoning law, ordinance or on' ' ...............
regulatl,
13. Will lot be regraded . . .~..~'t. · ' ............ ' ...........
..... ' .... ~ .~.~,~.. Wall exc~ fil~beyem~__o~d from premises: Yes
14. ~ame et Uwner ozpremises,~.,.~dress ~ .... Phone No.l~ .,~i~.~..~..·
Name of Architect ...... ~. ~l~'~..~' ..... : .-. ~.~A~Sress .. ~,l~'.~..'~..:.. Phone No ......... i..."
Name of Contractor .......................... Add.res,~~:: ~ Phone No ............
15. Is this property within 300 feet of a tidal wetl~nff7~... ..... N · ~
· *If yes, Southold Town Trustees Permit may be required[ -- o...~r .....
· -~ PLOT DIAGRAM
Locate clearly and distinctly all buildings, whethe~ existing or proposed, and. indicate~all ~et-back d/mensions from
proper~y Hnes. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot. MAIN ~O~D
~T~__ ~_.~ (N.YS. RTE
now or formerly
James R 8,,~,'~(Iry M.
O ~c 0 15OOO s f. o
~TATE OF NEW~-YOP, K,,
7OUNTY OF...~. ,~3¢)'(~..'.. S.S .,, / John J Misk¢, Jr a B~rb~r~ Ann
(Name of individual signing contract)
bore named.
Ieisthe .., ...............
~ 3ntractor, agent, corporate officer, etc.)
f said owner or owners, and is duly anthorized to perfom or have perfo~ed the said work and to m~e and file this
pplicat on; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the
'ark w~l be perfo~ed in the manner set forth in the application filed therewith.
worn to before me this
................ ........... m
No 4725089, Su~lk ~ ~ Si "' [ ' "'
· ~, ( gnature ofapphcant)
MARRATOOKA LANE
N io :~2'20"F. IO0.OO' U~UT~ .o~
/~~~ ,, ~ _
I ~ I~ r~* ~:' ~
~-L-_~ L ~ ' ~ , ~ ~ /
// ~~o=~ /~ -
0 ~ ~o O~
EO W. I00 00' ~
no~ or formerly
John J. Mi~k~
I
~ ~ ~ ~ o~ m
m< m 0
~ k F~~ -
Z
MARRATOOKA LANE
_~OVERH~AO UTILITY LINES ~10~ .._ I00.~' UTILITY POLE
~ I / I
· ~ ~ , I~ / I - ;
~ ' ~ //~ ~s ~ ~ '
' ~ I I
0 I / ~. . = ,
O ~ ~1 / ~ ,~ ,
~ · - .............~~ '~ '
o I STORY 0
~<i8~' "~"" '~
.
~ S.iO~2'20',W. i00.00,' ~ ~
now or formerly
John J. Misk~
'Z ~ m~ =. ,~5
, [ I I Ii III I ql. I Il I * ,' .'], ,, ' : ~il .:, [ I'